Provider Demographics
NPI:1447843404
Name:DUGGAR FAMILY PRACTICE
Entity type:Organization
Organization Name:DUGGAR FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DUGGAR
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:479-667-2923
Mailing Address - Street 1:107 NORTH 9TH STREET
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949
Mailing Address - Country:US
Mailing Address - Phone:479-667-2923
Mailing Address - Fax:
Practice Address - Street 1:107 NORTH 9TH STREET
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AR
Practice Address - Zip Code:72949
Practice Address - Country:US
Practice Address - Phone:479-667-2923
Practice Address - Fax:479-667-2857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty